Provider Demographics
NPI:1376733881
Name:VALLEJO, SHARIECE MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:SHARIECE
Middle Name:MARIE
Last Name:VALLEJO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 LOMITA BLVD STE 102
Mailing Address - Street 2:HARBOR-UCLA FAMILY HEALTH CENTER
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-2084
Mailing Address - Country:US
Mailing Address - Phone:310-534-6221
Mailing Address - Fax:
Practice Address - Street 1:1403 LOMITA BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-2076
Practice Address - Country:US
Practice Address - Phone:310-534-6221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program